Understanding Medicare

Understanding Medicare basics. Find answers to your questions about Medicare. Stop wasting time searching the web for answers when you can talk to #GAMedicareExpert Bob Vineyard?

Understanding Medicare basics
Understanding Medicare Basics

What is Medicare and how do I use it?

You should know that Medicare is health insurance designed primarily for folks age 65 and older. If you are younger than 65 you may qualify if you are disabled or have end stage kidney disease.

Original Medicare Has 4 Parts

Here is the key to understanding Medicare basic parts. Original Medicare has 4 parts. Your red, white and blue card is broadly accepted by doctors and hospitals alike.

No networks!

Never any referrals!

Prior authorization is not required!

The best part of Medicare 101.

Medicare Part A covers hospital inpatient charges and has a per admission deductible

Medicare Part B is for outpatient health care treatment. Doctor visits, labs, X-rays, MRI, CT scan (CAT scan), ambulance, ER, outpatient clinics, etc. Essentially any Medicare approved health care received outside the hospital setting. Treatment considered medically necessary under Medicare guidelines. Medicare Part B has a calendar year deductible. Once satisfied, Medicare pays 80% of the approved charge, you are responsible for the remaining 20%.

When you have original Medicare, YOUR DOCTOR AND YOU decide on the care you need. You don’t need approval by an insurance carrier before can receive testing or treatment.

You might be like most seniors and worry about hospital stays. But your major expenses will more than likely fall under Medicare Part B outpatient charges. Original Medicare stand alone does not cap on your out of pocket medical expenses.

You pay until you run out of money, get well or die.

Medicare 101 – Part C

Medicare Part C is now referred to as Medicare Advantage.

Did you know that some doctors and hospitals do not accept ANY Medicare Advantage plans? What happens if your claim is DENIED?

Medigap and Advantage plans cover the same things, but what you pay out of pocket for your care, and where you receive your care, is very different.

Did you know original Medicare does not have networks. You can use any doctor or hospital anywhere in the US. Another plus is the ABN form which is only used with Original Medicare.

Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO. How are Medicare Advantage plans like a store credit card?

If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.

Non-emergency out of network care charges may be denied if you have an HMO.

Why is Medicare Part D confusing?

Seniors often buy the wrong drug plan and spend too much on their prescription plan. Medicare beneficiaries spend an average of $3200 per year on prescription medications. – Kaiser Foundation

Lower your medication bill by using your drug card only when necessary. The right drug plan will save a lot on brand names but you will almost always pay MORE for generics.

Consider paying cash or using GoodRx instead for maximum savings. Also look for drug plans that have a deductible.

Basic Medicare Seems Simple

Medicare 101 may SEEM simple, but it is not. It is easy until you have a claim. Then it becomes complicated. Where will you turn then? Will you go to the friend that told you to buy the plan they have? Maybe you will call the agent that SOLD you the plan? Good luck with that. They may not even be in the business by now.

Maybe you will call the carrier where you went direct. You call an 800 number, press 1 for English then get routed to voice mail. Someone will call you back in a few days while you are in the shower.

Good luck with that.

Maybe your best choice is to find a GA Medicare expert.

Call now! Ask Bob Vineyard ANY Medicare question. NO SELLING! You ask questions. I offer answers. How easy is that?

Bob has worked for over 45 years in the insurance industry. His ONLY focus is Medicare and he is enrolled in Medicare.

Invest 10 minutes on the phone. Ask about Medicare Part A, B, C or D. When is the best time to sign up for Medicare? How can Advantage plans be free? Is Medicare supplement the same as an Advantage plan?

This is your time for understanding Medicare basics and how it works. If you are not satisfied then walk away. We part as friends. It’s not personal. It is just business.

Decide for yourself in you want Bob to be your agent. We more forward at YOUR pace, not mine. I call it an offer you can’t refuse.


#UnderstandingMedicareBasics #Medicare101 #GAMedicareExpert

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